Methods, systems and devices for delivering stents

ABSTRACT

A delivery device adapted to insert and deploy a stent within a body lumen. The delivery device includes a guide member adapted to retain a dilation assembly and a stent within a lumen thereof until the stent is to be deployed into the body lumen. The delivery device is configured to enable simultaneous insertion of the guide member, dilation assembly, stent, and optional guidewire within a body lumen. Following deploying the stent, the delivery device can be removed, while providing the capability of optionally maintaining the guide member or the guidewire to function or act as an exchange wire for additional surgical devices.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application claims priority to U.S. Provisional PatentApplication Ser. No. 60/344,661, filed Nov. 9, 2001, U.S. ProvisionalPatent Application Ser. No. 60/345,333, filed Nov. 9, 2001, U.S.Provisional Patent Application Ser. No. 60/347,500, filed Jan. 11, 2002,and U.S. Provisional Patent Application Ser. No. 60/341,092, filed Dec.12, 2001, the disclosures of which are herein incorporated by thisreference.

BACKGROUND OF THE INVENTION

1. The Field of the Invention

The invention generally relates to the field of interventionalcardiology. More specifically, the invention relates to interventionalcardiology procedures that require the placing of a stent in a bodylumen, such as a body lumen of a patient or animal. The presentinvention further relates to systems for providing embolic protectionduring placing of a stent in a body lumen.

2. The Relevant Technology

Human blood vessels often become occluded or blocked by plaque, thrombi,other deposits, or material that reduce the blood carrying capacity ofthe vessel. Should the blockage occur at a critical place in thecirculatory system, serious and permanent injury, and even death, canoccur. To prevent this, some form of medical intervention is usuallyperformed when significant occlusion is detected.

Several procedures are now used to open these stenosed or occluded bloodvessels in a patient caused by the deposit of plaque or other materialon the walls of the blood vessel. Angioplasty, for example, is a widelyknown procedure wherein an inflatable balloon is introduced into theoccluded region. The balloon is inflated, dilating the occlusion, andthereby increasing the intra-luminal diameter.

Another procedure is atherectomy. During atherectomy, a catheter isinserted into a narrowed artery to remove the matter occluding ornarrowing the artery, i.e., fatty material. The catheter includes arotating blade or cutter disposed in the top thereof. Also located atthe tip are an aperture and a balloon disposed on the opposite side ofthe catheter tip from the aperture. As the tip is placed in closeproximity to the fatty material, the balloon is inflated to force theaperture into contact with the fatty material. When the blade isrotated, portions of the fatty material are shaved off and retained withthe interior lumen of the catheter. This process is repeated until asufficient amount of fatty material is removed and substantially normalblood flow is resumed.

In another procedure, introducing a stent into the stenosed region toopen the lumen of the vessel treats stenosis within the artery or otherblood vessel. The stent typically includes a substantially cylindricaltube or mesh sleeve made from such material as stainless steel orNitinol. The design of the material permits the diameter of the stent tobe radially expanded, while still providing sufficient rigidity suchthat the stent maintains its shape once it has been enlarged to adesired size.

To place a stent, many medical devices are typically used. Once accessto the inside of the arterial system is established, usually through thefemoral artery, a guide catheter is inserted into the artery and the tipthereof is guided to a position just proximal to the stenosed region tobe treated. This guide catheter serves the purpose of allowing otherdevices to rapidly be delivered to that position without each beingcarefully guided from the point of access, through the tortuous anatomyof the arterial system to the point of intervention.

Typically, a small diameter guidewire is then inserted through the guidecatheter and guided to the point distal to the stenosed region. Whenguidewire access to the lesion is established, and if there issufficient cross sectional area in the narrowed part of the lesion, astent, mounted on a delivery device, is installed over the guidewire.When correctly placed within the stenosed region, the stent will then bedeployed, propping open the vessel at that point.

Various types of stents are used in these cases, but a common onerequires that the stent be deployed from, or expanded from, a compressedstate by a balloon upon which it is mounted. The balloon is inflatedfrom the proximal end of the delivery device to a high pressure, whichboth opens the stenosis and embeds the stent into the inner lumen of thevessel at that point.

Once the guidewire is placed, the guidewire is used as a guide for allof the other devices that are used in the procedure. These devices havean inner lumen through which the proximal end of the guidewire, which isoutside of the body of the patient, is inserted. The device is then slidalong the guidewire into the body, allowing the guidewire to guide thedevice to the required position in the vascular system. The process ofsliding another device over the guidewire is commonly known as anexchange.

Two basic types of devices facilitate exchanging of stent systems anddilation balloons. The first type of device encloses a guidewire withinan inner lumen of the device for the entire length of the device. Thesecond type of device only encloses the guidewire for a small distalsegment of the device, with the remainder of the guidewire exiting fromthe inner lumen of the device through a side hole to allow the deviceand the guidewire to be side by side. In both cases, control of theguidewire is paramount during the exchange as the correct positioning ofthe device is reliant upon maintaining the position of the guidewire;this being difficult as at least a section of the guidewire isinaccessible due to it being enclosed in the inner lumen of the devicebeing exchanged.

Providing a stent delivery device that reduces the complexity of aninterventional procedure would advance the art of stent delivery.Furthermore, reducing the number of devices used to perform a stentimplanting procedure would advance the art of stent delivery.

In addition, when these interventional procedures are performed, embolicparticles may break off, flow down-stream, and cause potential adverseevents. Devices are emerging that are designed to catch or filter theseparticles to prevent their down-stream flow, to occlude the vesselduring the intervention, and then allowing the particles to be aspiratedout before they may flow downstream.

Current technology for embolic protection devices requires that they bedelivered in a sheath distal to the point of intervention. This requirescrossing the lesion with a large-diameter, relatively stiff device thatis itself a potential embolic event that may occur before the embolicprotection device is in place. The sheath must then be removed allowingthe filter to be deployed in the vessel. After the device is deployed,balloons, stents, or other therapies of choice may be exchanged over thedevice to treat the area of interest. When the procedure is completed,the embolic protection device is captured by another catheter that isexchanged over the embolic protection device capturing any potentialembolic material within it. This relatively complicated procedure addscomplexity to providing stenting and other procedures.

The device and methods described herein are meant to overcomedeficiencies of the current devices allowing quicker, safer and easierprotection and stenting procedures to be undertaken.

BRIEF SUMMARY OF THE INVENTION

Embodiments of the present invention can provide systems, methods, anddevices that combine the functionality of a guidewire, a stent deliverydevice, a dilation balloon, and an embolic protection device, or subsetgrouping thereof, into a single device insertable into a body lumen. Inthis manner, embodiments of the present invention reduce the number ofdevices needed to perform a procedure, decrease the time needed toperform the procedure, reduce the difficulty and complexity of theprocedure, thereby creating the potential for safer procedures andincreased effectiveness to the patient.

In one embodiment, a delivery device includes a guide member having adistal end and a proximal end. The guide member functions as a guidecatheter, a guidewire, and a stent delivery device. A dilation assemblyis disposed at the distal end of the guide member with a stent preloadedupon the dilation assembly. The distal end of the guide member isconfigured to apply a restraining force upon the dilation assembly toselectively maintain the dilation assembly and stent within a lumen ofthe delivery device. Associated with the distal end of the guide memberis a restraining member or mechanism that can be operated to release therestraining force applied to the dilation assembly and stent, therebyallowing the dilation assembly and stent to be deployed from within thelumen. The restraining mechanism cooperates with an actuating assemblyto deploy the dilation assembly and stent.

In one embodiment, the actuating assembly cooperates with a proximal endof the guide member and includes an actuating member that extends fromthe restraining mechanism or member at a distal end of the deliverydevice to an actuating element disposed at the proximal end of the guidemember. Thus, operation of the actuating element translates movement tothe actuating member to release the restraining mechanism or member andrelease the restraining force applied by the restraining mechanism ormember, whether alone or in combination with the distal end of the guidemember, upon the dilation assembly and/or the stent.

In operation, the delivery device is placed in position within a bodylumen of a patient, with the dilation assembly and stent in a restrainedposition. Operation of the actuating assembly releases the dilationassembly and the stent from within the guide member. The guide membermay be pulled proximally to allow the dilation assembly and stent to beentirely free of the guide member. Alternatively, a dilation tube and/ora positioning member connected to the dilation assembly may be advanceddistally to deploy the dilation assembly and the stent. The stent maythen be placed in the vasculature by inflating the dilation balloonassociated with the dilation assembly, for example, through the dilationtube. After the stent is implanted, the dilation assembly is deflatedand the delivery device can be removed from the patient.

According to another aspect of the present invention, the deliverydevice can include an embolic protection device that is adapted tocollect embolic particles released during the procedure. As the stent isimplanted, the embolic protection device can filter the blood flowingpast the lesion and prevent embolic particles or matter flowingdownstream. In one configuration, the embolic protection device ismounted to a distal end of a guidewire associated with the deliverydevice. The embolic protection device can be a filter assembly thatincludes a filter and a filter basket. The filter basket includes aplurality of struts that restrain the filter during insertion of thedelivery device into the body lumen, while supporting and deploying thefilter upon releasing a restraining force applied to the plurality ofstruts to maintain the filter assembly in a closed position duringinsertion of the delivery device. The structures used to apply therestraining force to the plurality of struts can be similar to thestructures applying the restraining force to the dilation assemblyand/or stent.

According to another aspect of one embodiment of the present invention,the delivery device may cooperate with a capture mechanism or device forretrieving the filter assembly without removing the delivery device fromthe body.

Thus, the delivery devices of the present invention allow protectedinterventions to be accomplished with a single device insertion, withoutrequiring exchanges, while still allowing guidewire access distal to thetreatment region throughout the entire procedure.

These and other objects and features of the present invention willbecome more fully apparent from the following description and appendedclaims, or may be learned by the practice of the invention as set forthhereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

To further clarify the above and other advantages and features of thepresent invention, a more particular description of the invention willbe rendered by reference to specific embodiments thereof that areillustrated in the appended drawings. It is appreciated that thesedrawings depict only typical embodiments of the invention and aretherefore not to be considered limiting of its scope. The invention willbe described and explained with additional specificity and detailthrough the use of the accompanying drawings in which:

FIG. 1 illustrates a perspective view of an exemplary stent deliverydevice in accordance with one aspect of the present invention;

FIG. 2 illustrates a sectional side view of a distal end of the deviceof FIG. 1;

FIG. 3 illustrates a sectional side view of the distal end of the deviceof FIG. 1 with a distal end in an unrestrained configuration;

FIGS. 4 a and 4 b illustrate a sectional side view of the distal end ofthe device of FIG. 1 with a deployed dilation assembly;

FIG. 5 illustrates a sectional side view of the distal end of the deviceof FIG. 1 with associated inflated dilation balloon and implanted stent;

FIG. 6 illustrates a sectional side view of an exemplary proximal end ofthe device of FIG. 1 in accordance with another aspect of the presentinvention;

FIG. 7 illustrates a plan view of a distal end of another embodiment ofthe stent delivery device in accordance with another aspect of thepresent invention;

FIG. 8 illustrates a side view of the distal end of the stent deliverydevice of FIG. 7 in accordance with one aspect of the present invention;

FIG. 9 illustrates a perspective view of a distal end of anotherembodiment of a stent delivery device in accordance with one aspect ofthe present invention;

FIG. 10 illustrates a perspective view of the distal end of the stentdelivery device of FIG. 9 with deployed dilation assembly in accordancewith one aspect of the present invention;

FIG. 11 illustrates a perspective view of another embodiment of a stentdelivery device of the present invention;

FIG. 12 illustrates another perspective view of the distal end of thedelivery device of FIG. 11 before a restraining member is coupled to thedelivery device;

FIG. 13 illustrates a perspective view of the distal end of the deliverydevice of FIG. 11, illustrating the restraining member partially coupledto the delivery device;

FIG. 14 illustrates a side view of another restraining mechanism usablewith the delivery device of FIG. 11 in accordance with one aspect of thepresent invention;

FIG. 15 illustrates a perspective view of another embodiment of thestent delivery device in accordance with one aspect of the presentinvention;

FIG. 16 illustrates a perspective view of the distal end of the deliverydevice of FIG. 15 before a restraining mechanism is coupled to thedelivery device;

FIG. 17 illustrates a side view of the delivery device of FIG. 15illustrating the restraining member partially coupled to the deliverydevice;

FIG. 18 illustrates a side view of the delivery device of FIG. 15illustrating the restraining member partially coupled to the deliverydevice;

FIG. 19 illustrates a side view of the delivery device of FIG. 15illustrating the restraining member partially coupled to the deliverydevice;

FIG. 20 illustrates a perspective view of another embodiment of a stentdelivery device in accordance with another aspect of the presentinvention;

FIG. 21 illustrates a perspective view of another embodiment of a stentdelivery device in accordance with another aspect of the presentinvention;

FIG. 22 illustrates a side view of the delivery device of FIG. 21 beforethe restraining mechanism is coupled to the delivery device;

FIG. 23 illustrates a side view of the delivery device of FIG. 21illustrating the restraining member partially coupled to the deliverydevice;

FIG. 24 illustrates a perspective view of the delivery device of FIG. 21having the restraining mechanism coupled to a distal end thereof;

FIG. 25 illustrates a perspective view of a proximal end of anotherembodiment of a stent delivery device in accordance with another aspectof the present invention;

FIG. 26 illustrates a perspective view of a proximal end of yet anotherembodiment of a stent delivery device in accordance with another aspectof the present invention;

FIG. 27 illustrates a perspective view of a proximal end of yet anotherembodiment of a stent delivery device in accordance with another aspectof the present invention;

FIG. 28 illustrates another embodiment of the proximal end of anotherembodiment of a stent delivery device in accordance with another aspectof the present invention;

FIG. 29 illustrates a sectional side view of another embodiment of astent delivery device of the present invention in accordance withanother aspect of the present invention;

FIG. 30 illustrates a sectional side view of the distal end of the stentdelivery device of FIG. 30 in accordance with another aspect of thepresent invention;

FIG. 31 illustrate sectional side views of another embodiment of a stentdelivery device in accordance with another aspect of the presentinvention;

FIG. 32 illustrates a sectional side view of another embodiment of astent delivery device in accordance with another aspect of the presentinvention;

FIG. 33 illustrates a sectional side view of another embodiment of astent delivery device in accordance with another aspect of the presentinvention;

FIG. 34 illustrates a sectional side view of yet another embodiment of astent delivery device in accordance with another aspect of the presentinvention;

FIG. 35 illustrates a sectional side view of still another embodiment ofa stent delivery device in accordance with another aspect of the presentinvention;

FIG. 36 illustrates a sectional side view of another embodiment of astent delivery device in accordance with another aspect of the presentinvention;

FIG. 37 illustrates a sectional side view of an embodiment of a stentdelivery device that includes an embolic protection device in accordancewith another aspect of the present invention;

FIG. 38 illustrates a sectional side view of a distal end of thedelivery device of FIG. 37;

FIG. 39 illustrates a sectional side view of a portion of the deliverydevice of FIG. 37 with a filter assembly deployed in accordance withanother aspect of the present invention;

FIG. 40 illustrates a sectional side view of a portion of the deliverydevice of FIG. 37 with the filter assembly and the stent deployed inaccordance with another aspect of the present invention;

FIG. 41 illustrates a perspective view of a restraining mechanism for afilter assembly usable with the delivery device of FIG. 37 in accordancewith another aspect of the present invention;

FIG. 42 illustrates a perspective view of a filter assembly usable withthe delivery device of FIG. 37 in accordance with another aspect of thepresent invention;

FIG. 43 illustrates a perspective view of the embodiment of the filterassembly of FIG. 42 in accordance with another aspect of the presentinvention;

FIG. 44 illustrates a perspective partial sectional view of a distal endof another embodiment of a delivery device in accordance with anotheraspect of the present invention;

FIG. 45 illustrates a perspective view of an embodiment of a capturemechanism according to one aspect of the present invention; and

FIG. 46 illustrates a perspective view of another embodiment of acapture mechanism according to one aspect of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention provides systems, methods, and devices thatcombine the functionality of a guide catheter, a guidewire, a stentdelivery device, a dilation balloon, and/or an embolic protectiondevice, or a subset group of such devices, into a single device that isinsertable into a body lumen. In this manner, the present inventionreduces the number of devices needed to deliver and position a stent,providing the possibility of decreasing the time needed to performprocedures and reducing the difficulty and complexity associated withperforming a procedure. Further, embodiments of the present inventionaid with decreasing the possibility of patient complications during andsubsequent to the procedure.

Referring now to FIG. 1, depicted is an exemplary embodiment of adelivery device of the present invention, designated by reference number10. As illustrated, delivery device 10 includes a guide member 12 havinga distal end 14 and a proximal end 16. The term “guide member” can referto any structure that is capable of functioning as a guidewire that canbe steered through the tortuous anatomy of a patient. It will beappreciated that guide member 12 can be hollow or partially hollowdepending upon design considerations.

Extending between distal end 14 and proximal end 16 of guide member 12is a lumen 18 within which is disposed a dilation assembly 40 and astent 42 (see FIG. 2). Distal end 14 of guide member 12 includes a tip15 that is configured for percutaneous insertion into a body lumen,while proximal end 16 either includes or is adapted to cooperate with anactuating assembly 20 that is adapted to deploy dilation assembly 40and/or stent 42.

Illustratively, guide member 12 can have an outside diameter of betweenabout 0.010 inches to about 0.650 inches and an inside diameter ordiameter of lumen 18 from about 0.004 inches to about 0.55 inches.Additionally, guide member 12 can be fabricated from a variety ofdifferent materials. For example, guide member 12 can be fabricated fromNitinol, steel, metals, metal alloys, composites, plastic, polymers,synthetic materials, such as, but not limited to, PEEK, Rydel, orcombinations thereof. Additionally, guide member 12 can have theconfiguration of a braid-reinforced polymer tube or a rigid polymertube. Furthermore, guide member 12 can be covered with one or morecoatings. For instance, and not by way of limitation, guide member 12can include one or more coatings that improve lubricity, reduce plateletaggregation, or have anti-thrombogenic properties. In addition to theabove, guide member 12 can include one or more hydrophilic coatings,heparinized coatings, Polytetrafluoroethylene (PTFE) coatings, siliconecoatings, combinations thereof, or other coatings that may aid withpositioning guide member 12 and/or preventing damage to the body lumen.

Optionally, guide member 12 may include one or more cuts, slits,grooves, or other structures, illustratively identified by numeral 17,that provide flexibility to all or a portion of guide member 12.Although reference is made to use of cuts, slits, or grooves to provideflexibility, it can be appreciated by one skilled in the art that guidemember 12 or other portion of device 10 may have a lattice structure,i.e., portions of guide member 12 or device 10 removed therefrom, whichprovides flexibility to a portion of guide member 12 and/or otherportion of device 10.

The cuts, slits, or grooves can be located at any location of guidemember 12 and may have various pitches to allow or provide for differentflexibilities. These one or more grooves, cuts or slits can partially orcompletely extend through portions of guide member 12. Additionally,these grooves, cuts, or slits can have a variety of differentconfigurations, such as but not limited to, straight, helical,geometric, combinations thereof, or various other configurations knownto those skilled in the art, so long as those same provide flexibilityto guide member 12. Further, any number of grooves, cuts, or slits canbe included in guide member 12 and optionally portions of dilationassembly 40. For example, the more grooves, cuts, or slits included inguide member 12 or a portion of dilation assembly 40, the greater theflexibility of guide member 12, and hence delivery device 10. Similarly,the depth of each groove, cut, or slit can vary depending upon thedesired flexibility. For instance, the deeper the groove, cut, or slit,the greater the flexibility of guide member 12, and hence deliverydevice 10. Furthermore, differences in the configuration of each groove,cut, or slit can affect the flexibility of guide member 12 and thereforedelivery device 10. For instance, the steeper the sides of a particulargroove, cut, or slit, the less flexibility provided to guide member 12and/or delivery device 10.

FIG. 1 depicts dilation assembly 40 and stent 42 (FIG. 2) disposed attip 15 of guide member 12. Dilation assembly 40 terminates in anatraumatic tip 48. Dilation assembly 40 and stent 42 are retained at tip15 of guide member 12 by a restraining mechanism or restraining member25. In the embodiment of FIG. 1, an actuating member 28 operatesrestraining member 25 and extends to an actuating assembly 20 disposedat a proximal end of device 10. Actuating member 28 extends to theproximal end of device 10 and is exposed to allow the restraint appliedby restraining member 25 to be released as a clinician moves actuatingmember 28 in a proximal direction. Alternatively, actuating member 28can optionally extend outside guide member 12 to proximal end 16 ofdevice 10.

Dilation assembly 40 is connected to a dilation tube 44 that extendsalong the length of guide member 12. Dilation tube 44 is used to fill adilation balloon 46 with a fluid. The fluid may be introduced through aluer lock fitting 45 located at proximal end 16 of guide member 12.Dilation tube 44 may also be used, in some embodiments, as a positioningmember for deploying dilation assembly 40 and stent 42. Additionally,dilation assembly 40 of device 10 is coupled by dilation tube 44 toactuating element 21. By sliding actuating element 21 with respect toproximal end 16 of guide member 12, dilation assembly 40 is moved withrespect to guide member 12 and can be deployed from tip 15 of guidemember 12. These and other features of the present invention will now bedescribed in further detail.

With reference now to FIG. 2, distal end 14 of guide member 12 includesone or more struts 24 that are adapted to retain dilation assembly 40and stent 42 within lumen 18 until the same are to be deployed. Eachstrut 24 can be biased to extend outwardly to release dilation assembly40 and stent 42. Although reference is made to each strut 24 beingbiased to extend outwardly, it can be understood by one skilled in theart that each strut 24 need not be biased to extend outwardly.

The one or more struts 24 can be formed using a variety of differentprocesses. For instance, the processes can include, but not limited to,machining processes performed using a laser or conventional machiningprocess, including, but not limited to, hydro-machining, grinding, endmilling, slitting saws, abrasive saws, electrical discharge machines,combinations thereof, or other machining processes capable of creatingslots or slits sufficient to form one or more struts 24. In theembodiment of FIG. 2, each strut 24 can be formed integrally with guidemember 12. In other embodiments, one or more of struts 24 are formed aspart of a discrete strut assembly that is attached to guide member 12.

Surrounding struts 24 is restraining member 25. In the embodiment ofFIG. 2, restraining member 25 is a sleeve 26. Sleeve 26 is adapted toretain or maintain struts 24 in a restrained or closed configuration sothat the combination of sleeve 26 and struts 24 maintain dilationassembly 40 and stent 42 within lumen 18. Sleeve 26 is adapted tocooperate with the exterior of guide member 12 so that sleeve 26 can bedisplaced in a proximal direction to release struts 24. Since struts 24,in this exemplary configuration, are biased to extend outwardly, uponmoving sleeve 26 in a proximal direction, struts 24 extend outwardly torelease dilation assembly 40 and stent 42.

Sleeve 26 can be fabricated from various types of materials so long assleeve 26 is capable of securely retaining struts 24. For instance,sleeve 26 can be fabricated from heat shrink synthetic material,including but not limited to, low-density polyethylene (LDPE),polyethylene terphthalate (PET), Polytetrafluoroethylene (PTFE),fluorinated ethylene propylene (FEP), polyethylene (PE), polyurethane(PU), silicone tubing, and other suitable polymers or syntheticmaterials.

Actuating member 28 extends from sleeve 26, travels along an exterior ofguide member 12, and passes through an aperture 30 in guide member 12.Actuating member 28 continues to travel within lumen 18 of guide member12 until it reaches proximal end 16 of guide member 12. It will beappreciated that in other embodiments, actuating member 28 may remainexternal to lumen 18 of guide member 12.

Actuating member 28 can be fabricated from various materials and havevarious configurations so long as it is capable of performing thefunction of displacing sleeve 26. For example, actuating member 28 canbe fabricated from plastics, polymers, metals, composites, alloys,synthetic materials, and combinations thereof.

As shown in FIG. 2, dilation assembly 40 includes a dilation balloon 46mounted to a dilation tube 44. Dilation tube 44 extends from distal end14 of guide member 12 toward proximal end 16 of guide member 12.Dilation tube 44 can include a plurality of holes 50. Each hole 50and/or plurality of holes 50 in combination provide a fluid path to aninterior 52 of dilation balloon 46. In this way, fluid may pass along alumen 54 of dilation tube 44 to flow into dilation balloon 46. Torestrict the flow of such fluid, atraumatic tip 48 seals the distal endof dilation tube 44. In addition to providing a fluid path to inflatedilation balloon 46, holes 50 provide a fluid path to deflate dilationballoon 46 or remove the fluid to deflate dilation balloon 46. Each hole50 can have various configurations so long as each hole 50 is capable ofallowing fluid to pass therethrough.

Dilation tube 44, in one configuration, is an internal support fordilation balloon 46 and stent 42. Dilation tube 44 can be fabricatedfrom Nitinol, steel, metals, metal alloys, composites, plastic, andcombinations thereof. Further, dilation tube 44 can be covered with avariety of different coatings, such as, but not limited to, one or morecoatings to improve lubricity, anti-thrombogenic properties, and reduceplatelet aggregation. Other coatings can include, but not limited to,hydrophilic coatings, heparinized coatings, Polytetrafluoroethylene(PTFE) coating, silicone coating, or combinations of the coatingsdescribed herein.

Dilation tube 44 may have a variety of different configurations andembodiments. In another embodiment, dilation tube 44 includes a proximalend where provision is made for connecting dilation tube 44 to aninflation device with an annular clamping device, such as a touhy-borstadaptor. Alternatively, as shown in FIG. 1, a proximal end of dilationtube 44 has the form of a luer fitting, whether the male or female partof the luer fitting.

Mounted to a distal end of dilation tube 44 is an atraumatic tip 48.Atraumatic tip 48 is disposed within lumen 54 of dilation tube 44 andseals dilation tube 44, prevents fluid from escaping therefrom duringinflation and deflation of dilation balloon 46, and provides a flexibletip that aids in positioning and steering of delivery device 10 throughthe tortuous anatomy of the patient. In the illustrative embodiment,dilation tube 44 extends to a distal end of dilation balloon 46 andatraumatic tip 48 is disposed therein. Alternatively, dilation tube 44can extend to a position proximal to the distal end of dilation balloon46 and a portion of atraumatic tip 48 then extends from a distal end ofdilation tube 44 to a position distal to the distal end of dilationballoon 46. Furthermore, in another alternate embodiment, dilation tube44 terminates within a lumen formed in atraumatic tip 48.

Atraumatic tip 48 includes a core 56 that is surrounded by a flexiblecoil 58. As shown, flexible coil 58 terminates at a distal end of tip 48with an atraumatic portion, such as a solder ball or other mechanism forforming an atraumatic distal end of tip 48. More generally, atraumatictip 48 can have a variety of other configurations so long as atraumatictip is flexible and optionally shapeable. Furthermore, atraumatic tip 48may be radiopaque to allow steerable positioning of delivery device 10while allowing a physician or clinician to observe the location of tip48 using appropriate devices, such as a fluoroscopic device or X-raydevice. Materials that facilitate or provide radiopacity may include,but not limited to, platinum, alloys of platinum, gold, or combinationsthereof, metals, alloys, plastic, polymer, synthetic material,combinations thereof, or other materials that provide an appropriateradiopaque signature, while capable of being shaped by a physician orclinician. Alternatively, tip 48 can be a polymer that is dipped orcoated with an appropriate radiopaque material, such as, but not limitedto, barium sulphate, bismuth subcarbonate, titanium dioxide, orcombinations thereof.

Referring now to FIG. 3, depicted is distal end 14 of delivery device 10upon disposition of sleeve 26 in a proximal direction. In thisillustrative configuration, because struts 24 are biased to extendoutwardly, dilation assembly 40 and stent 42 can be deployed from withinlumen 18. Deploying of dilation assembly 40 and stent 42 can occur asguide member 12 is displaced in a proximal direction, dilation tube 44is displaced in a distal direction, or a combination of proximal anddistal movements of guide member 12 and dilation tube 44 respectively.

Referring now to FIG. 4 a, schematically depicted is delivery device 10in a deployed configuration where dilation assembly 40 and stent 42 havebeen deployed at a lesion 70 of a body lumen 72. Deployment of dilationassembly 40 and stent 42 can be achieved through manipulating actuatingassembly 20 (FIGS. 1 and 2). Upon positioning dilation balloon 46 andstent 42 to the desired position, such as adjacent to lesion 70, fluidcan be introduced through lumen 54 of dilation tube 44 to expanddilation balloon 46 and therefore deploy or force stent 42 into bodylumen 72 and surrounding lesion 70, as is illustrated in FIG. 5.

Various configurations of stent 42 are known to those skilled in theart. For example, an expandable stent may be used that automaticallyopens under the pressure of dilation balloon 46. In anotherconfiguration, a self-expanding stent can be used, as illustrated inFIG. 4 b with dotted lines. The self-expanding stent automatically opensas the restraining force applied by struts 24 and/or restraining member25 is removed and guide member 12 is moved proximal to the stent. Inthis case, the self-expanding stent surrounds dilation balloon 46, asillustrated in FIG. 4 b, or alternatively, the stent can surrounddilation tube 44 with dilation balloon 46 being located proximal to thestent and still mounted to dilation tube 44, as illustrated by dottedlines referenced by numeral 46 b. Various stents may be used with thepresent invention, so long as the stent can be reduced in size tosurround the dilation balloon and be disposed within guide member 12 ofdelivery device 10.

Referring now to FIG. 6, depicted is an exemplary embodiment ofactuating assembly 20 that can be used to deploy dilation balloon 46 andstent 42. Operating actuating assembly 20 releases dilation assembly 40and stent 42 from a restrained configuration at distal end 14 of guidemember 12. More specifically, dilation balloon 46 forming part ofdilation assembly 40 can be deployed with stent 42 being disposedsubstantially around dilation balloon 46.

As illustrated, actuating assembly 20 includes an actuating element 21coupled to a proximal end of dilation tube 44. Actuating element 21includes a distal end 74 configured to be mounted to and cooperate withproximal end 16 of guide member 12. A proximal end 76 of actuatingelement 21 is attached to a proximal end of dilation tube 44, while aproximal end of actuating member 28 passes through a sealed aperture 47of actuating element 21. In this exemplary embodiment, the proximal endof dilation tube 44 includes a luer fitting 45 that allows variouscomplementary luer fittings to be attached thereto. For instance, asyringe (not shown) can be attached to luer fitting 45 for introducingfluid to and removing fluid from dilation balloon 46 (FIG. 5) duringinflation and deflation of dilation balloon 46. Although reference ismade to use of luer fitting 45, it can be understood by one skilled inthe art that various other configurations of fitting can be attached toor formed at the proximal end of dilation tube 44.

Actuating element 21 is adapted to be displaced in a distal direction todeploy dilation assembly 40 and stent 42. To aid with positioningactuating element 21, distal end 74 can have a step configuration andinclude protrusions 78 that mate with complementary indentations 80formed in proximal end 16 of guide member 12. The protrusions 78 andindentations 80 provide an indication of the relative position ofdilation assembly 40 and stent 42 relative to distal end 14 of guidemember 12. Therefore, actuating element 21 and/or guide member 12 caninclude one or more protrusions and indentations. As actuating element21 is displaced in a distal direction, protrusions 78 mate withindentations 80. To seal lumen 18 of guide member 12, one or more seals84 surround protrusions 78. Additionally, one or more seals (not shown)can surround dilation tube 44 and/or actuating member 28.Illustratively, each seal can be one or more O-rings in one or moregrooves, one or more O-rings, a gasket, or a viscous fluid seal.

When actuating element 21 is displaced in the distal direction, distalend 74 contacts a wall or stop 82 formed in guide member 12 thatprevents further displacement of actuating element 21 in the distaldirection. Through this configuration, actuating element 21 is preventedfrom excessive longitudinal displacement in the distal direction. Thisstopping of the longitudinal displacement of actuating element 21indicates that dilation balloon 46 and stent 42 are deployed from withinlumen 18 of guide member 12 to the desired position for expanding orimplanting stent 42.

Although reference is made to one manner of indicating the particularlocation of stent 42, one skilled in the art can identify a variety ofdifferent embodiments. For instance, a plurality of indentations and/orprotrusions can be included within actuating element 21 and guide member12 to control the distance which actuating element 21 and, consequently,stent 42 is displaced. In another configuration, a wall or stop formedin actuating element 21 can mate with the distal end of guide member 12to prevent excessive longitudinal displacement in the distal direction.In still another configuration, a combination of one or more walls orstops in actuating element 21 and guide member 12 can be used. In stillanother configuration, distal end 74 of actuating element 21 can betapered and cooperate with a taper formed in proximal end 16 of guidemember 12. The complementary tapers control the longitudinaldisplacement of actuating element 21 relative to proximal end 16 ofguide member 12. In still other configurations, a combination ofindentations, protrusions, walls, stops, threads, or tapers can be used.Various other manners are known to control the distance traveled byactuating element 21 while indicating the position of stent 42.

In addition to the above, it can be appreciated that actuating element21 can include one or more elements, such that wall or stop 82 andindentations 80 are formed in separate elements or members that areattached or coupled to proximal end 16 of guide member 12. By so doing,actuating element 21 can be fabricated separately from guide member 12,thereby reducing costs and expenses associated with fabricating proximalend 16 of guide member 12 in the desired configuration.

FIGS. 7 through 24 illustrate alternative embodiments for restrainingmechanism 25. It will be appreciated that many features of the deliverydevices depicted in FIGS. 7 through 24 are substantially similar instructure and function as for delivery device 10. Consequently, featuresand functions of one embodiment of the present invention are applicableto other embodiments of the present invention.

Referring now to FIGS. 7 and 8, another illustrative embodiment of adelivery device 100 of the present invention is depicted. As shown, aguide member 112, which can be similar to the other guide membersdescribed herein, has a distal end 114, a proximal end (not shown), anda lumen 118 extending from distal end 114 to the proximal end. A tip 115of guide member 112 includes a plurality of struts 124, such as two ormore struts. Each strut 124 can be optionally biased so that a distalend of each strut 124 moves outwardly from a longitudinal axis of guidemember 112 when each strut 124 is released by a restraining member 125.Although reference is made to each strut 124 being biased, one skilledin the art can appreciate that one or more of struts 124 can be biased.

As shown in FIG. 8, at least one strut, designated by reference numeral124 a, is biased toward the longitudinal axis of guide member 112.Disposed upon strut 124 a, as more clearly seen in FIG. 7, is anatraumatic tip 148. This atraumatic tip 148, either alone or incombination with strut 124 a, may be shapeable by a physician orclinician before insertion into a body lumen. In this manner, thephysician or clinician is able to configure tip 148 with an appropriateshape, such as, but not limited to a “J” shape, which enables guidemember 112 to be guided through the tortuous anatomy of a patient. Allor a portion of atraumatic tip 148 can be fabricated from platinum,platinum alloys, radiopaque materials, materials doped or coated with aradiopaque material, metals, alloys, plastic, polymer, syntheticmaterial, combinations thereof, or other materials that provide anappropriate radiopaque signature, while are capable of being shaped,whether alone or in combination with strut 124 a, by a physician orclinician. In this configuration, a guidewire with an associateddilation assembly can be disposed within lumen 118, with a distal end ofthe guidewire optionally including a flexible atraumatic tip, sinceatraumatic tip 148 can function as the atraumatic tip for deliverydevice 100.

To maintain struts 124 in a restrained position, i.e., not extendingoutwardly from guide member 112, restraining member 125 surrounds struts124. The restraining member 125 and other restraining members ormechanisms described herein are examples of means for applying arestraining force upon one or more struts or means for applying arestraining force upon a distal end of a guide member. In thisembodiment, restraining member 125 can extend completely or partiallyfrom the distal end to the proximal end of guide member 112. Forexample, restraining member 125 can surround substantially only struts124 or can have a configuration similar to those depicted in FIGS. 9-24.

In the configuration depicted in FIGS. 7 and 8, restraining member 125or means for applying a restraining force is a catheter 127 that appliesa force against struts 124 to prevent struts 124 from extendingoutwardly or applies a force against struts 124 to maintain a dilationassembly 140 and a stent 142 in lumen 118. Through displacing guidemember 112 with respect to catheter 127, or vice versa, the forceapplied to struts 124 is released and, in one configuration, the distalends of struts 124 are allowed to move outwardly to allow dilationassembly 140 and stent 142 to be deployed.

As mentioned above, catheter 127 can extend completely or partially thelength of the guide member. In another configuration, catheter 127 canbe replaced with a sleeve or other structure that completely orpartially extends toward the proximal end of guide member 112 from thedistal end. These alternate configurations are also means for applying arestraining force, as described herein. These restraining members ormechanisms can be radiopaque or include one or more radiopaque markersthat aid with positioning the device. Furthermore, these restrainingmembers or mechanisms can be slidable relative to the guide member usingan actuating member and/or an actuating assembly disposed on an exteriorof the guide member, within a lumen of the guide member, or partiallywithin the lumen and partially on the exterior of the guide member. Theactuating assembly may be similar in structure and function to actuatingassembly 20 described in FIG. 6 or any other actuating assemblydescribed herein. Therefore, systems, methods, and devices of thepresent invention can optionally use catheters, sleeves, bands, or otherstructures described herein interchangeably to perform the desiredfunction of restraining one or more struts or a distal end of the guidemember.

FIGS. 9 and 10 depict another embodiment of a delivery device 200 of thepresent invention. As illustrated, delivery device 200 includes a guidemember 212 with a plurality of struts 224 disposed at a distal end 214thereof. Struts 224 are maintained in a restrained position using arestraining member 225. In this embodiment, restraining member 225 is asleeve 226 surrounding struts 224. Sleeve 226 acts as a restrainingmember or mechanism that applies a force against the struts to preventthe struts from extending outwardly or to maintain the dilation balloonand/or stent within the lumen.

Struts 224, when in a restrained position, maintain dilation assembly240 and stent 242 within lumen 218 of guide member 212. Disposed withinsleeve 226 or between sleeve 226 and guide member 212 are one or moreactuating members 228. Actuating members 228, optionally forming part ofthe restraining mechanism or member, are attached to guide member 212 ata location proximal to the proximal end of each strut 224, identified byletter A. Actuating members 228 extend distally to the distal end ofsleeve 226 and subsequently extend proximally on the outside of sleeve226 to terminate at the proximal end (not shown) of device 200. Sinceone end of each actuating member 228 is located at the proximal end ofsleeve 226, whether forming part of sleeve 226, attached to sleeve 226,attached to guide member 212, or combinations thereof, displacingactuating member 228 in the proximal direction causes actuating member228 to preferentially separate sleeve 226 into one or more portions 232,illustrated in dotted lines. By so doing, struts 224 are released, asillustrated in FIG. 10.

To operate actuating members 228, a proximal end (not shown) ofactuating member 228 extends to a proximal end (not shown) of guidemember 212, either within or without lumen 218 of guide member 212.Actuating members 228 can extend to an actuating element (not shown) ofan actuating assembly, such as, but not limited to, the actuatingassembly of FIG. 6 and other actuating assemblies described herein andunderstood by one skilled in the art in light of the teachings containedherein. The actuating member 228 can be displaced in the proximaldirection relative to guide member 212. By so doing, the restrainingforce applied by sleeve 226 is released, struts 224 extend outwardly,and dilation assembly 240 and/or stent 242 are deployed.

Sleeve 226 can be formed from a variety of different materials, so longas the material is sufficiently strong to secure struts 224, while beingconfigured to preferentially separate under the action of actuatingmembers 228. For example, sleeve 226 can be fabricated from heat shrinksynthetic material, including but not limited to, low-densitypolyethylene (LDPE), polyethylene terphthalate (PET),Polytetrafluoroethylene (PTFE), fluorinated ethylene propylene (FEP),polyethylene (PE), polyurethane (PU), or silicone tubing.

The one or more actuating members 228 can be formed from a variety ofdifferent materials, so long as the material used is sufficiently strongto allow an actuating assembly, such as, but not limited to, thoseactuating assemblies disclosed herein, to displace actuating member 228proximally without breaking the same. For example, actuating members 228can be fabricated from plastics, polymers, metals, composites, alloys,synthetic materials, and combinations thereof.

Instead of using actuating members 228, embodiments of the presentinvention can employ various other means to preferentially separatesleeve 226. For example, sleeve 226 can have dissolvable chemical bondswhich dissolve due to a chemical reaction with the fluid in the bodylumen within which the delivery device is disposed, bonds that arebroken through applying resistive heating, ultrasonic, or radiofrequency energy to actuating members 228 and/or region of the bodylumen containing device 200, preferential tear or cut regions or zoneswhere the material has a weaker strength than other regions or zones ofthe sleeve, or combinations thereof.

Referring now to FIGS. 11 through 14, depicted is an embodiment of adelivery device 300 having another embodiment of a restraining member ormechanism 325. In this embodiment, restraining member 325 is in the formof a sleeve 326 which is adapted to surround one or more struts 324 of aguide member 312 and apply a restraining force against struts 324 tomaintain struts 324 in a restrained configuration. Sleeve 326 includes afirst side 364 and a second side 366 with first and second sides 364,366 being separated by an intermediate portion 368. Intermediate portion368 surrounds guide member 312 in such a manner that portions ofintermediate portion 368 contact, are juxtaposed to, are contiguouswith, or are adjacent to one another. An actuating member 328 passesthrough such portions of intermediate portion 368 to secure sleeve 326upon guide member 312. To further aid with applying a restraining forceagainst struts 324, first side 364 and second side 366 are folded toattach to respective portions of outside surface of sleeve 326.

The process of forming the restraining member or mechanism of FIG. 11 isillustrated in FIGS. 12 and 13. With reference first to FIG. 12, whichdepicts sleeve 326 in an open position before actuating member 328 iscoupled thereto, sleeve 326 can be directly formed on guide member 312or can be formed on a separate tubular member and subsequently attachedor coupled to guide member 312. Sleeve 326 is illustrated as having agenerally polygonal configuration, however, one skilled in the art canappreciate that sleeve 326 can have various other configurations so longas it is capable of performing the functions described herein. In thisexemplary configuration, sleeve 326 is coupled directly to guide member312. First side 364 and second side 366 of sleeve 326 are wrapped aroundat least a portion of guide member 326, until a portion of intermediateportion 368 is in close proximity with another portion of intermediateportion 368, as illustrated in FIG. 13. Alternatively, a first side 364can contact second side 366 or be juxtaposed, contiguous, or adjacent tosecond side 366.

When the portions of intermediate portion 368 are in close proximity,actuating member 328, or alternatively some other actuating member, isstitched through both portions of sleeve 326 to couple the portions ofintermediate portion 368, as shown in FIG. 13. Once actuating member 328is drawn substantially straight or otherwise positioned through sleeve326, first end 364 and second end 366 are respectively folded to attachto respective outside surfaces of sleeve 326, as shown in FIG. 11.

As illustrated in FIG. 14, in an alternate configuration, sleeve 326 caninclude a plurality of apertures 360 on portions of intermediate portion368 that receive actuating member 328. In this manner, actuating member328 can pass through apertures 360 rather being stitched through sleeve326. In another embodiment, first end 364 of sleeve 326 can be coupledto second end 364 of sleeve 326 without attaching first end 364 orsecond end 366 to the outside surface of sleeve 326. In still anotherconfiguration, a portion of first end 364 can overlap a portion ofsecond end 366, or vice versa. Alternatively, first end 364 and secondend 366 contact each other but do not overlap. Similarly, first end 364and second end 366 can be adjacent to one another, adjoining oneanother, contiguous to one another, or juxtaposed to one another.

To operate the restraining member or mechanism described in reference toFIGS. 11-14, a proximal end of actuating member 328 extends to aproximal end of guide member 312, either within or without a lumen ofthe guide member 312. Upon displacing actuating member 328 in a proximaldirection relative to guide member 312, vice versa, or combinationthereof, actuating member 328 is released from being disposed through atleast a portion of sleeve 326. By so doing, the restraining forceapplied by sleeve 326 is released, struts 324 extend outwardly, and thedilation assembly and/or stent are deployed. A clinician or physiciancan initiate the longitudinal motion of actuating member 328, eitherdirectly or through using of an actuating mechanism or device.

Sleeve 326 can be formed from a variety of different materials, so longas the material is sufficiently strong to restrain one or more struts324. For example, sleeve 326 can be fabricated from various types ofpolymer or silicone films, such as but not limited to, heat shrinkplastic, polymer, low-density polyethylene (LDPE), polyethyleneterphthalate (PET), Polytetrafluoroethylene (PTFE), fluorinated ethylenepropylene (FEP), polyethylene (PE), polyurethane (PU), or siliconetubing.

Actuating member 328 can be formed from a variety of differentmaterials, so long as the material used is sufficiently strong to allowthe actuating assemblies disclosed herein to displace actuating member328 proximally without breaking actuating member 328. For example,actuating member 328 can be fabricated from plastics, polymers, metals,composites, alloys, synthetic materials, combinations thereof, or othermaterial that is capable of performing the function of being disposedthrough sleeve 326 and capable of being withdrawn therefrom.

Referring now to FIGS. 15-19, illustrated is another embodiment of adelivery device 400 having an alternate configuration of a restrainingmember or mechanism. This particular embodiment utilizes a restrainingmember or mechanism 425 having a hinged configuration with an actuatingmember 438, optionally forming part of restraining member or mechanism425, acting as the pin to maintain the hinged portions of therestraining member in a configuration that retains or restrains aportion of the guide member.

As shown in FIG. 15, restraining member 425 is a sleeve 426 having aplurality of channels 464 a-464 f that are adapted to receive actuatingmember 428. Both a first side 466 and a second side 468 of sleeve 426are formed with some of channels 464 a-464 f, i.e., channels 464 a, 464c, and 464 e on first side 466 and channels 464 b, 464 d, and 464 f onsecond side 468. By passing actuating member 428 through channels 464a-464 f in sequential order, so that actuating member 428 passes througha channel on first side 466 and subsequently a channel on second side468, first side 466 is coupled to second side 468 and sleeve 426 appliesa restraining force against struts 424 of guide member 412.

An exemplary process of forming the restraining member or mechanism ofFIG. 15 is illustrated in FIGS. 16-19. With reference first to FIG. 16,which depicts sleeve 426 in an open position before actuating member 428is coupled thereto, sleeve 426 includes a number of extensions ortongues 460 a-460 f. These extensions 460 a-460 f are configured to formchannels 464 a-464 f and surround a tubular member or tube, such as, butnot limited to, a guide member 412 within which actuating member 428 islocated.

To attach sleeve 426 to guide member 412, sleeve 426 is positioned overthe desired portion of guide member 426. Actuating member 428 is placedin close proximity to guide member 412, as shown in FIGS. 17-19. Theends of the extensions 460 a-460 f are inserted between guide member 412and actuating member 428, as shown in FIG. 18. Alternatively, extensions460 a-460 f can be partially wrapped around guide member 412 andactuating member 428 placed into contact with these partially wrappedextensions 460 a-460 f.

After the extensions 460 a-460 f are pulled tightly around guide member412 and actuating member 428, an end of each extension 460 a-460 f isfolded over actuating member 428 to attach to the outer surface ofsleeve 426, as shown in FIGS. 15 and 19. In this manner, channels 464a-464 f are formed and sleeve 426 is configured with actuating member428 to releasably restrain struts 424 of guide member 412.

Releasing the restraining force applied by sleeve 426, alone or incombination with actuating member 428, is achieved through displacingactuating member 428 longitudinally with respect to guide member 412,vice versa, or combination thereof. Actuating member 428 is releasedfrom channels 464 a-464 f to allow the biasing force of struts 424 toextend the struts outwardly to deploy dilation assembly and/or stent. Aclinician or physician can initiate the longitudinal motion of actuatingmember 428, either directly or through using of an actuating mechanismor device.

Referring now to FIG. 20, depicted is another delivery device 500 havinganother embodiment of a restraining member or mechanism 525 of thepresent invention. The restraining member 525 includes a cord 529forming a number of hoops 564 a-564 n. One or more of hoops 564 a-564 nare adapted to receive an actuating member 528, which is optionally partof restraining member or mechanism 525. The actuating member 528 isdisposed within hoops 564 a-564 n so that cord 529 applies a restrainingforce against struts 524 of guide member 512. Actuating member 528 canbe removed from hoops 564 a-564 n to thereby allow struts 524 to extendoutwardly to deploy the dilation assembly and/or stent. Cord 529 may bemade from metallic wires, polymer actuating members, or other materialsthat can be manipulated to form hoops through which an actuating orsecuring member. Optionally, cord 529 is adapted to expand outwardlyeither under the influence of one or more struts or due to a biasingforce applied or incorporated within cord 520 by the configurationand/or material of the cord, the hoops, and/or the restraining member.

Cord 529 can be attached to guide member 512 and/or one or more of thestruts associated therewith through various attachment mechanisms. Forinstance, cord 529 can be attached to guide member and/or one or more ofthe struts through adhesives, mechanical fasteners, securing loops, orother manner that securely attaches cord 529 to guide member 512 and/orone or more of struts 524. Alternatively, cord 529 may be attached toactuating member 528 and be removed when actuating member 528 is movedin a proximal direction. A clinician or physician can initiate thelongitudinal motion of actuating member 528, either directly or throughusing of an actuating mechanism or device.

Referring now to FIGS. 21-24, depicted is another delivery device 600having another embodiment of a restraining member or mechanism 625 ofthe present invention. As illustrated, a guide member 612 includes aplurality of struts 624 that are adapted to extend outwardly to enabledeployment of the stent and dilation balloon disposed within a lumen 618of guide member 612. A restraining member 625 restrains struts 624. Thisrestraining member 625, in one configuration, is a flexible member 627configured with flaps 660 and 662. The flaps 660 and 662 extend betweena gap 664 between the two adjacent struts 624 a and 624 b and areadapted to be pulled around struts 624 to compress stent (not shown) anddilation balloon (not shown) within lumen 618, as illustrated in FIG.23. These flaps 660 and 662 can be two separate members that are bondedor otherwise connected to struts 624 a and 624 b or a single member thatis coupled to struts 624 a and 624 b while forming flaps 660 and 662.

When flaps 660 and 662 have been positioned to securely retain struts624, they are then stitched together at a location 666, identified inFIG. 23, with an actuating member 628. This actuating member 628,optionally forming part of the restraining member or mechanism, extendsthe length of delivery device 600 toward an actuating assembly, such as,but not limited to, the actuating assembly described in FIG. 6 and otheractuating assemblies known to those skilled in the art in light of theteachings contained herein. A clinician or physician can initiatelongitudinal motion of actuating member 628 to release restrainingmember or mechanism 625, either directly or through using of anactuating mechanism or device as known to those skilled in the art.

Following coupling of flaps 660 and 662 using actuating member 628,flaps 660 and 662 are folded back around struts 624 and the remainder offlaps 660 and 662, and then attached to struts 624, or other portion ofguide member 612, as illustrated in FIG. 24. When actuating member 628is displaced in a proximal direction, flaps 660 and 662 are released andstent (not shown) and dilation balloon (not shown) are deployed asstruts 624 extend outwardly.

Referring now to FIG. 25, depicted is an illustrative embodiment of aproximal end of a delivery device 700 a. The features and structuresdiscussed with other embodiments of the delivery device of the presentinvention apply to delivery device 700 a.

As shown, a proximal end 716 of a guide member 712 terminates in a guidemember housing 722. This guide member housing 722 can be integrallyformed with guide member 712 or alternatively be a separate membercoupled, connected, or attached to a proximal end of guide member 712.Proximal end 716 of guide member 712 is coupled to an actuating element721 of an actuating assembly 720. This actuating element 721 slidablyengages with guide member housing 722. Manipulation of actuating element721 effects the movement of dilation tube 744 upon which is mounted thedilation balloon (not shown). Actuating member 728 extends through anaperture 786 in actuating element 721 that is adapted with a seal (notshown) through which actuating member 728 can slide. In this manner,aperture 786 and the seal (not shown) allow access for the operator torelease or displace the restraining member (not shown) that restrainsthe one or more struts (not shown) disposed at distal end 714 ofdelivery device 700 a. The seal can include a polymer gasket, such as,but not limited to, polyurethane, silicone rubber, or other materialsthat are capable of making a seal around actuating member 728 and allowthe actuating member 728 to slide therethrough while a fluid seal ismaintained.

A dilation tube 744, optionally having a similar configuration todilation tube 44 of FIG. 1, extends from a distal end 714 of guidemember 712 through guide member housing 722 to terminate and be attachedto proximal end 776 of actuating element 721. As depicted, proximal end776 of actuating element 721 includes a luer fitting 745, which isadapted to cooperate with a complementary luer fitting for inflating anddeflating a dilation balloon (not shown) disposed at distal end 714 ofguide member 712.

In this illustrative embodiment, an additional luer fitting 790 isformed in or coupled to actuating element 721. Luer fitting 790 isprovided to infuse fluid through a lumen 718 of guide member 712,thereby allowing introduction of a contrast media in the blood flowaround the vicinity of the device as it is advance in the vasculature.

Referring now to FIG. 26, an alternate configuration of delivery device700 a is depicted as illustrated delivery device 700 b. In thisconfiguration, the engagement between actuating element 721 and guidemember housing 722 can be achieved through complementary threads 792formed in actuating element 721 and guide member housing 722. Thesecomplementary threads 792 can be configured to allow longitudinalmovement of actuating element 721 relative to guide member housing 722through rotational motion of actuating element 721 or motion parallel tothe longitudinal axis of guide member 712. By using threads 792, veryprecise control of the longitudinal movement of the dilation balloon(not shown) and stent (not shown) disposed at distal end 714 of guidemember 712 can occur.

Although reference is made to using complementary threads, it can beunderstood by one skilled in the art in light of the teaching containedherein that various other structures can be used to provide controllablelongitudinal movement of actuating element 721 relative to guide memberhousing 722. For instance, actuating element 721 can include a key thatmates with a key way formed in guide member housing 722, or vice versa.Further, although reference is made to rotational motion and motionparallel to the longitudinal movement of the dilation balloon and stent,one skilled in the art can identify various other directions of motionthat can enable or facilitate deployment of the dilation balloon and/orstent. For instance, the motion of actuating element can be at anyangular orientation relative to the longitudinal axis of the guidemember, whether or not such motion includes one or more revolutions ofthe actuating element relative to the guide member.

As depicted in FIG. 27, another embodiment of delivery device 700 c isillustrated. To aid with moving actuating element 721 relative to guidemember housing 722, actuating element 721 and guide member housing 722and/or guide member 712 can include optional handles 796 and 798respectively. These handles 796 and 798 can optionally include grippingregions that are adapted to cooperate with one or more appendages of auser of the device. In another configuration, each handle 796 and 798can have a substantially constant cross-section along their lengths. Instill other configurations, each handle 796 and 798 can have variablecross-sections along their lengths. Additionally, although a single luerfitting 745 is depicted in FIG. 27, it can be understood by one skilledin the art that delivery device 700 c can include one or more fittingsto facilitate introduction of one or more fluids to an interior ofdelivery device or to a dilation balloon.

FIG. 28 shows yet another embodiment of delivery device 700 d in whichactuating element 721 includes a housing 760 that contains a rotatablegear 762 adapted to cooperate with complementary features or structures770 formed in a proximal end of guide member 712. The gear 762, withassociated one or more teeth, features or structures 768, can bemanipulated or rotated by an actuator 764 as a clinician or otherindividual selects an actuator member 766 and rotates actuator 764 torotate gear 762. Optionally, actuator 764 has one or more teeth,features or structures that can cooperate with gear 762, such thatrotational motion of actuator 764 is translated to movement of gear 762.

As actuator 764 and hence gear 762 are rotated, the complementaryfeatures 770 of guide member 712 mate with the teeth, features orstructures 768 of gear 762 to move guide member 712 in a proximal and/ordistal direction, dependent upon the rotational direction of actuator764. By so doing, the dilation assembly and the stent can be deployedfrom a distal end (not shown) of device 700 d.

In addition to moving or positioning guide member 712, actuating member728 may also be operated through using a sliding switch 762 associatedwith housing 760 and actuating element 721. The actuating member 728 iscoupled to a leg 762 that is attached to switch 762, while slidingswitch 762 is slidably coupled to housing 760. The sliding translationof switch 762 moves actuating member 728 in the respective direction torelease a restraining force applied by the restraining member ormechanism (not shown) of device 700 c. One skilled in the art canidentify various other configurations of actuating element 721 in lightof the teaching contained herein.

Referring now to FIGS. 29-37, depicted are various configurations ofalternative embodiments of a delivery device in accordance with thepresent invention. The features and functions of other describeddelivery devices apply to the discussion of delivery devices 800 athrough 800 g. Furthermore, it will be appreciated that the majority offeatures and functions described with respect to delivery device 800 aalso apply to delivery devices 800 b through 800 g described furtherbelow. The delivery devices of FIGS. 29-37 illustrate variousembodiments wherein a delivery device is adapted to be used with aguidewire. For ease of explanation, the embodiments of FIGS. 29-37 donot include a restraining member or mechanism that restrains thedilation assembly and stent inside the guide member. However, it will beappreciated that any restraining member or mechanism with any actuatingassembly, as disclosed herein or understood by those of skill in theart, may be employed with devices 800 a-800 g.

As shown in FIG. 29, delivery device 800 a includes a guide member 812having a proximal end 816 and a distal end 814, with a lumen 818extending from distal end 814 toward proximal end 816. The distal end814 can have a similar configuration to the other guide member distalends described herein. For instance, a restraining member (not shown)may be disposed at distal end 814 to cooperate with structures adaptedto restrain a dilation assembly 840 and/or a stent 842. Disposed atproximal end 816 is a guide member housing 822 that cooperates with anactuating element 821 of an actuating assembly 820, in a similar mannerto that described with respect to FIG. 6.

Extending from an aperture 834 in a proximal end of actuating element821 toward distal end 814 of guide member 812 is a guidewire 832. Asshown best in FIG. 30, guidewire 832 cooperates with a dilation assembly840 disposed at a distal end of guide member 812. In this illustrativeconfiguration, dilation assembly 840 includes a tubular member 836 thatcooperates with a dilation balloon 846 coupled or attached thereto. Thetubular member 836 can function as a positioning member that facilitatesdeployment of dilation assembly 840 and stent 842. The guidewire 832extends through tubular member 836 that allows dilation balloon 846, anda stent 842 coupled to dilation balloon 846, to be moved along guidewire832 when necessary. The internal diameter of a lumen of tubular member836 is complementary to the exterior diameter of guidewire 832.

Guidewire 832 terminates at a distal end with an atraumatic tip 848 thatcan include a core wire 856 wrapped with a coiled spring 858. The corewire 856 may be an extension of the remainder of guidewire 832 oralternatively may be a separate member coupled or attached to the distalend of guidewire 832. In either case, core wire 856 can be made from thesame or a different material than guidewire 832 and may optionally be asolid member or a tubular member.

The dilation balloon 846 of dilation assembly 840 is inflated through adilation tube 844 that extends from dilation balloon 846 to terminate atthe proximal end of actuating element 821 with a luer fitting 845. Anadditional luer fitting 890 may be provided attached to actuatingelement 821. It will be appreciated that luer fitting 890 can performsubstantially the same function as luer fitting 790.

The distal end of dilation tube 844 cooperates with an interior ofdilation balloon 846. The distal end of dilation tube 84 can beconnected to tubular member 836, dilation balloon 846, or to bothtubular member 836 and dilation balloon 846. The dilation tube 844 canbe used to position dilation balloon 846 and/or stent 842 during aprocedure. Consequently, dilation tube 844 can have sufficient strengthto enable distal movement of dilation tube 844 to translate to distalmovement of the remainder of dilation assembly 840. Similarly, dilationtube 844 can have sufficient strength to enable proximal movement ofdilation tube 844 to translate to proximal movement of the remainder ofdilation assembly 840.

Delivery device 800 a is configured so that guidewire 832 can bepositioned in a body lumen, and delivery device 800 a can be removedfrom within the body lumen while retaining guidewire 832 at the desiredposition. As such, other conventional, interventional devices may thenbe used to complete the procedure. A device may be connected to thedistal end of the guidewire such as, for example, a filter assembly forcollecting embolic particles that are dislodged in the body vesselduring a stenting operation, as will be discussed in greater detailhereinafter. Other devices may be exchanged over guidewire 832 as willbe understood by those of skill in the art.

Depicted in FIG. 31 is another embodiment of a device 800 b. The device800 b includes a dilation assembly 840 b that is adapted to cooperatewith a guidewire 832. As shown, dilation assembly 840 b includes atubular member 836 that cooperates with an expandable dilation balloon846. Disposed at a proximal end of tubular member 836 is a positioningmember 838. The positioning member 838 is coupled to a proximal end oftubular member 836 to facilitate transfer of forces applied topositioning member 838 to tubular member 836 to position dilationassembly 840. The positioning member 838 can be coupled or attached totubular member 836, dilation balloon 846, or both tubular member 836 anddilation balloon 846, whether such coupling or attachment occurs at aproximal end, distal end, or other portion of tubular member 836 and/ordilation balloon 846 between the respective proximal ends and distalends thereof. Similarly, the coupling or attaching of positioning member838 to one or both of tubular member 836 and dilation balloon 846 can beto or upon internal and/or external surfaces of tubular member 836 anddilation balloon 846. By so doing, positioning member 838 can bemanipulated by a physician or clinician to position dilation assembly840 b in the desired location to dilate a stent (not shown) and/orlesion. For instance, positioning member 838 can be used to slidedilation balloon 846 along guidewire 832.

As shown, positioning member 838 is separate from dilation tube 844.Although reference is made to positioning member 838 being separate fromdilation tube 844, it can be ,appreciated that positioning member 838can be removably disposed within dilation tube 844, while being capableof positioning dilation balloon 846 in the desired location within thebody lumen or vessel. For instance, as illustrated in dotted lines inFIG. 31, extending from tubular member 836 or formed in tubular member836 is a stop 837 that can cooperate with a distal end of a positioningmember 838 disposed within a lumen of dilation tube 844. By moving thepositioning member in the distal direction, the distal end of thepositioning member cooperates with stop 837 to move dilation assembly840 b in the distal direction. To move tubular member 836 in theproximal direction, a clinician or physician can move dilation tube 844in a proximal direction. In another configuration, stop 837 can includea recess (not shown) that friction fits or otherwise cooperates with thedistal end of the positioning member, such that the positioning memberis retained in the recess with sufficient force that the positioningmember can move the tubular member 836 in both proximal and distaldirections.

The proximal end of guide member housing 822 as illustrated in FIG. 31,cooperates with an actuating assembly 821 b, while a distal end 814 ofguide member 812 cooperates with a restraining member or mechanism (notshown) and is adapted to aid in applying a restraining force to dilationassembly 840 b and/or stent 842. Actuating element 821 b is adapted toenable a clinician to operate delivery device 800 b to deliver stent842, such as in a similar manner to the device described in FIG. 29. Forinstance, positioning member 838 can be coupled to actuating element 821b such that distal movement of actuating element 821 b moves dilationassembly 840 b.

In addition, the proximal end of actuating element 821 b includes anannular clamping mechanism 862, such as, but not limited to, touhy-borstadaptor, compressible polymer or silicone rubber gasket, or otherclamping mechanisms 862 known to those skilled in the art in light ofthe teaching contained herein. The annular clamping mechanism 862receives guidewire 832 and creates a mechanical connection and a fluidseal between actuating element 821 b and guidewire 832. This sealprevents fluid escaping from within lumen 818, while providing amechanism for releasing delivery device 800 b from guidewire 832 in theevent that other conventional, interventional devices are to be usedwithout loosing the vascular access that is gained by the device as awhole. For example, by rotating annular clamping mechanism 862, the sealis broken and delivery device 800 b can be removed from guidewire 832. Asimilar clamp or other seal can cooperate with positioning member 838 toprevent fluid escaping from within device 800 b.

FIG. 32 depicts another embodiment of delivery device 800 c. In thisembodiment, tubular member 836 extends substantially between distal end814 and proximal end 816 of guide member 812. Tubular member 836 isadapted to receive guidewire 832 therethrough. Thus, tubular member 836extends from a distal end of dilation balloon 846 to a proximal end ofguide member 812, such that the proximal end of tubular member 836terminates at a point proximal to a proximal end of dilation tube 844.Additionally, the proximal end of tubular member 836 cooperates with aproximal end of guide member 812 and/or an actuating element 821 cdisposed at the proximal end of guide member 812.

Actuating element 821 c includes a fixed portion 829 and a movableportion 831 slidably disposed with portion 829. The portion 829 can beintegrally formed with a proximal end of guide member 812 or a separatemember that is coupled or attached to the proximal end of guide member812, where such coupling or attaching can be achieved by complementarythreads, key and keyway configuration, chemical bonding, thermalbonding, or adhesives.

The portion 831 cooperates with portion 829 in sealing manner so that afluid entering an interior space defined by the interiors of portion 829and a portion of portion 831 is prevented from exiting therefrom. Thisseal can be created by one or more sealing members 833 and/or betweenthe tolerances associated with portion 829 and portion 831.Illustratively, sealing member 833 can be one or more O-rings in one ormore grooves, one or more O-rings, gasket, or viscous fluid seal.

The portion 831 contains a support structure 823 extending across adistal end thereof. The proximal end of tubular member 836 is fixedlyattached to support structure 823. Support structure 823 also includesan aperture 825 through which extends guidewire 832. Preferably, a seal827 is disposed between and/or within aperture 825 and guidewire 832 toretain fluid inside guide member 812. Consequently, upon depressingportion 831 in the direction of arrows A, dilation balloon 846 isdeployed from within lumen 818 of guide member 812. Similarly, uponmoving portion 831 of actuating element 821 c in the direction of arrowsB, dilation balloon 846 is retracted into lumen 818 of guide member 812.

As depicted in FIG. 33, another embodiment of delivery device 800 d isillustrated. In this embodiment, dilation balloon 846 is coupled orattached directly to guidewire 832. Consequently, positioning member 838is connected to guidewire 832 and/or optionally dilation balloon 846instead of tubular member 836. Positioning member 838 is manipulatableby a physician, clinician, or the like to position dilation assembly 840in the desired location to dilate the stent and lesion. Consequently, bymoving positioning member 838, dilation balloon 846 can be placed in theposition to optionally pre-dilate the lesion and/or dilate the lesionduring implanting of stent 842.

FIG. 34 illustrates another embodiment of delivery device 800 e. In thisembodiment, positioning member 838 is connected to dilation balloon 846.Positioning member 838 is manipulatable by a physician, clinician, orother individual to position dilation assembly 840 in the desiredlocation to dilate the stent and lesion. Consequently, by movingpositioning member 838, dilation balloon 846 can be placed in theposition to optionally pre-dilate the lesion and/or dilate the lesionduring implanting of a stent (not shown).

Guidewire 832 passes between dilation balloon 846 and stent 842.Although not depicted for ease of explanation, guidewire 832 may have anatraumatic tip attached or formed at a distal end thereof. The dilationballoon 846 includes an integrally formed dilation tube 844 that extendsfrom a distal end of dilation balloon 846. The dilation balloon 846, aswith other dilation balloons described herein, can have variousconfigurations, such that dilation balloon 846 can having substantiallyconstant cross-section along its length or alternatively have a variablecross-section along its length. Furthermore, the dilation balloons ofthe present invention can be formed from one or more separate dilationballoons, with associated one or more dilation tubes, which collectivelyprovide the functionality of a single dilation balloon.

In addition, FIG. 34 depicts a tip 864 disposed at distal end ofguidewire 832. Tip 864 provides a transition between guidewire 832 andguide member 812 to limit the potential of damaging the body lumen orvessel of the patient during insertion and removal of delivery device800 e during a procedure. Various types of tips are known to thoseskilled in the art, such as, but not limited to, those discussed hereinand others known to one skilled in the art in light of the teachingcontained herein. For instance, tip 864 can have various configurationsso long as the configuration provides a transition between guidewire 832and guide member 812 to aid in preventing damage to the body lumen orvessel during insertion and removal of delivery device 800 e. Further,tip 864 can be coupled or attached to guidewire 832 through variousmanners, such as, but not limited to, adhesives, mechanical bonds,thermally created bonds, being integrally formed therewith, orcombinations thereof.

As depicted in FIG. 35, illustrated is another embodiment of deliverydevice 800 f. In this embodiment, guidewire 832 passes between guidemember 812 and dilation assembly 840 to terminate distally of a distalend of guide member 812. Although not depicted for ease of explanation,guidewire 832 may have an atraumatic tip attached or formed at a distalend thereof. Connected to dilation balloon 846 is a positioning member838, similar to those described herein. Positioning member 838 ismanipulatable by a physician, clinician, or other individual to positiondelivery device 800 f in the desired location to dilate the stent andlesion. Consequently, by moving positioning member 838, dilation balloon846 can be placed in the position to optionally pre-dilate the lesionand/or dilate the lesion during implanting of stent 842. Delivery device800 f also includes a tip 864, similar in structure and function to thetip 864 shown and discussed with respect to FIG. 34.

FIG. 36 illustrates yet another embodiment of a delivery device of thepresent invention. As shown, a delivery device 800 g includes a dilationassembly 840 g, which may be similar to other dilation assembliesdescribed herein, which is disposed past a distal end 814 of guidemember 812. Guide member 812 acts as a positioning member to positiondilation assembly 840 g in the desired location to dilate the stent andlesion. Consequently, by moving guide member 812, dilation balloon 846can be placed in the position to pre-dilate the lesion and/or dilate thelesion during implanting of a stent. Although not depicted for ease ofexplanation, guidewire 832 may have an atraumatic tip attached or formedat a distal end thereof.

FIGS. 37 through 44 depict another aspect of the present invention.During a procedure to dilate a lesion and/or implant a stent at alesion, often emboli becomes dislodged and is carried downstream in thebody vessel. To prevent the emboli from blocking even smaller bodyvessels further downstream, one or more embodiments of the presentinvention can include means for providing embolic protection. The meansfor providing embolic protection can be included in a delivery devicehaving a unitary configuration where the delivery device and the meansfor provide embolic protection, such as a filter device, can be insertedinto a body lumen substantially simultaneously.

Referring to FIG. 37, an exemplary delivery device 900 is depictedhaving many of the same features and functionality of the deliverydevices heretofore described. Consequently, the descriptions of thevarious other delivery devices described herein apply to delivery device900. As illustrated, delivery device 900 includes a guide member 912having a dilation assembly 940 and stent 942 disposed therein. It willbe appreciated that in the embodiment of FIG. 37 and subsequentembodiments hereafter, a restraining member or mechanism, illustrated indotted lines, may be disposed at distal end 914 of guide member 912 torestrain dilation assembly 940 and stent 942 adjacent or near distal end914 of guide member 912 until deployment of same is desired. It will beappreciated that any restraining member or mechanism may be employed asdisclosed herein or understood by those of skill in the art.Furthermore, appropriate structures may be employed for deployingdilation assembly 940 and stent 942 as described herein or understood bythose skilled in the art.

With continued reference to FIG. 37, delivery device 900 has a filterassembly 931 disposed distally of guide member 912. Consistent withteachings of the present invention, delivery device 900 has a guidewire932 disposed through dilation assembly 940 and optionally through filterassembly 931. In the illustrated configuration, guidewire 932 terminatesat filter assembly 931, with the filter assembly 931 being coupled to adistal end of guidewire 932 and includes an atraumatic tip, as will bedescribed in more detail below.

Filter assembly 931 is adapted to provide embolic protection during useof device 900. As depicted in FIGS. 37 and 38, filter assembly 931 has alow profile to facilitate insertion of the same with a body lumen. Atransition member 936 is disposed between filter assembly 931 anddilation assembly 940. The transition member 936 is adapted to provide atransition between guide member 912 and filter assembly 931. Thistransition prevents damage to the body lumen within which device 900 isdisposed and prevents catching upon a wall or junction of one or morebody lumens as device 900 is steered through the tortuous anatomy of apatient. As illustrated, transition member 936 includes a passageway 938disposed therethrough for receiving guidewire 932. Passageway 938 can beadapted to securely retain guidewire 932 therein or optionally removablyreceive guidewire 932. Alternatively, transition member 936 can includea hole through which guidewire 932 passes or is received. In stillanother configuration, transition member 936 includes a hole adapted toreceive a distal end of guidewire 932, while a distal end of transitionmember 936 is formed or cooperates with filter assembly 931.

FIGS. 37 and 38 illustrate filter assembly 931 being restrained inpreparation for deploying filter assembly 931, while FIGS. 39-41 depictfilter assembly 931 being deployed or activated. As shown in FIG. 41,filter assembly 931 includes a filter basket 934 and a filter 933.Before deployment, filter 933 can be disposed inside filter basket 934,surround filter basket 934, or a combination thereof. The filter 933 isadapted to capture embolic particles or material that may becomedislodged during a procedure associated with delivery device 900 oroptionally other procedures when delivery device 900 is optionallyslidably removed from guidewire 932 and associated filter assembly 931.Consequently, filter 933 can optionally float within a body lumen uponbeing deployed, with a distal end of filter 933 floating in the bodylumen and the proximal end of filter 933 being coupled to filter basket934. In another configuration, a distal end of filter 933 can be coupledto a portion of filter basket 934.

The filter 933 can be fabricated from a variety of different materials,such as, but not limited to, a woven or braided plastic or metallicmesh, a perforated polymer film, a Nitinol mesh, combinations thereof,or other material that is capable of capturing material within flowingblood, while allowing the blood to flow through the pores or aperturesthereof. Generally, filter 933 can be fabricated from a variety ofmaterials so long as filter 932 is capable of being packed within filterbasket 934, and optionally float in the blood flow or stream passingthrough the body lumen within which it is inserted, and isbio-compatible.

Filter 933 can have a variety of differently sized pores ranging fromabout 50 microns to about 200 microns, from about 60 microns to about180 microns, or from about 75 microns to about 150 microns. Forinstance, the pores can have a variety of different configurations, suchas but not limited to circular, oval, polygonal, combinations thereof orother configurations known to one skilled in the art in light of theteaching contained herein. In one configuration, therefore, filter 933can include pores that are differently sized and configured.Consequently, a major or minor axis of each pore can have a variety ofdifferent sizes ranging from about 50 microns to about 200 microns, fromabout 60 microns to about 180 microns, or from about 75 microns to about150 microns. Generally, the pore size can vary as needed, so long as thepores are sized so that the pores do not compromise blood flow throughthe filter, i.e., prevent blood flowing through the filter, and collectmaterial that could potentially occlude smaller downstream vessels,potentially blocking blood flow to tissue or result in stroke orinfarction.

In addition to the above, filter 933 can be coated with a hydrophiliccoating, a heparinized coating, a Polytetrafluoroethylene (PTFE)coating, a silicone coating, combinations thereof, or various othercoatings as know or desired by one skilled in the art in light of theteaching contained herein.

The filter basket 934 supports filter 933 following deployment of filter933. The filter basket 934 includes a plurality of struts 960 thatextend from a body 962. Struts 960 of filter basket 934 are adapted toextend outwardly to position filter 933 within the body lumen. A strut960 a of struts 960 can include an atraumatic tip 948, with struts 960 aforming at least a portion of the core wire of atraumatic tip 948. Thisstrut may also be covered with a flexible coil 958. The body 962 offilter basket 934 includes a hole 967 that is adapted to receiveguidewire 932. Alternatively, body 962 can include a passageway that isadapted to receive a distal end of guidewire 932.

The filter 933 can be attached to struts 960 of filter basket 934 in avariety of ways. For instance, filter 933 can be attached throughadhesives, solvent bonding, thermal bonding, mechanical connections, orcombinations thereof. Further, the distal end of two or more struts 960can include a hole through which strands of filter media 932 can bepassed and attached to struts 960. Alternatively, the strands can betied in a knot, folded back upon filter 933, and affixed to filter 933.Various other manners exist of coupling or connecting filter 933 tofilter basket 934.

Optionally, filter assembly 931 includes a number of radiopaque bandsand/or markers affixed to a variety of positions on filter assembly 931.For instance, bands, markers or other means for radiopacity can beincluded upon filter 933, filter basket 934 and/or struts 960. In otherconfigurations, the delivery device generally includes means forradiopacity at one or more locations or positions thereof to aid withviewing the position of the delivery device and the various elements andcomponents thereof.

As illustrated, a restraining member or mechanism 925 restrains struts960, while another retraining member, shown in dotted lines, restrains adistal end of guide member 912. Optionally, restraining member ormechanism 925 restrains both the distal end of guide member 912 andstruts 960. FIGS. 37 and 38 depict restraining member or mechanism 925restraining struts 960, while FIGS. 39-41 depict struts 960 beingreleased from restraining member or mechanism 925. In the exemplaryconfiguration of FIG. 41, restraining member or mechanism 925 has asimilar configuration to restraining member or mechanism 525. Therefore,restraining member or mechanism 925 includes a cord 929 forming a numberof hoops, with one or more of the hoops being adapted to receive anactuating member 928, which is optionally part of restraining member ormechanism 925. The actuating member 928 is disposed within the hoops sothat cord 929 applies a restraining force against struts 960. Actuatingmember 928 can be removed from the hoops to thereby allow struts 960 toextend outwardly to deploy filter 933. Cord 929 may be made frommetallic wires, polymer actuating members, or other materials that canbe manipulated to form hoops through which an actuating or securingmember. Optionally, cord 929 is adapted to expand outwardly either underthe influence of one or more struts or due to a biasing force applied orincorporated within cord 929 by the configuration and/or material of thecord, the hoops, and/or the restraining member.

Cord 929 can be attached to one or more struts 960 of filter assembly931 through various attachment mechanisms. For instance, cord 929 can beattached to guide member and/or one or more of the struts throughadhesives, mechanical fasteners, securing loops, or other manner thatsecurely attaches cord 929 to one or more of struts 960. Alternatively,cord 929 may be attached to actuating member 928 and be removed whenactuating member 928 is moved in a proximal direction. A clinician orphysician can initiate the longitudinal motion of actuating member 928,either directly or through using of an actuating mechanism or device.Although reference is made to one particular embodiment of restrainingmember or mechanism 925, one skilled in the art can appreciate thatother restraining members or mechanism described herein can be used torestrain struts 960.

As shown, filter basket 934 includes one or more holes 970 that areadapted to receive at least a portion of restraining member or mechanism925. The holes 970 can be disposed at various locations of filterassembly 931. For instance, and not by way of limitation, body 962 andeach strut 960 can include one or more holes 970. The restraining memberor mechanism 925 can be at least partially disposed through one or moreof holes 970, with cord 929 or other portion of restraining member ormechanism 925 being optionally releasably coupled to one of struts 960or body 962 of filter basket 934. Moving actuating member 928 ofrestraining member or mechanism 925 in a proximal direction causesstruts 960 to move outwardly to release filter 933.

A proximal end (not shown) of restraining member or mechanism 925 oractuating member 928 can be accessible by a clinician or physician toallow the same to operate restraining member or mechanism 925 to releasethe restraining force applied to struts 960. Optionally, the proximalend of restraining member or mechanism 925 can cooperate with anactuating assembly that can be operated to move restraining member ormechanism 925 as needed to release the restraining force applied byrestraining member or mechanism 925.

In the illustrative configuration of FIGS. 37-41, actuating member 928of restraining member or mechanism 925 can be moved in a proximaldirection with sufficient movement and force to be removed fromengagement with the hoops of cord 929. By breaking the coupling orengagement between actuating member 928 and cord 929, struts 960 areallowed to expand or move outwardly to deploy filter 933. Followingdeploying filter 933, an actuating assembly (not shown) can bemanipulated to deploy dilation assembly 940 and stent 942 from guidemember 912, in a similar manner to that described herein, and asillustrated in FIG. 40. Therefore, two actuating assemblies can be used,one to release restraining member or mechanism 925 and one to releasedilation assembly 940 and stent 942.

It will be appreciated that restraining member or mechanism 925 is butone means for restraining struts 960 of filter basket 934. Otherconfigurations may be employed, such as, but not limited to, therestraining configurations or means for restraining described in FIGS.2-24. For instance, struts 960 of filter basket 934 can be restrained inthe same manner as the strut associated with the guide member of thepresent invention.

Turning to FIG. 40, depicted is delivery device 900 with filter assembly931 deployed and dilation assembly 940 and stent 942 deployed from guidemember 912. Deploying of dilation assembly 940 and stent 942 can beachieved in a similar manner to that described with respect to otherdilation assemblies and stents discussed herein. Similarly, manipulatingrestraining member or mechanism 925 to release struts 960 and deployfilter 933 can deploy filter assembly 931. Through moving guide member912 relative to guidewire 932, vice versa, or combinations thereof,dilation assembly 940 and stent 942 can be released from within guidemember 912.

FIGS. 42 and 43 illustrate another embodiment of a filter assembly 1031.Filter assembly 1031 has another embodiment of a mechanism forrestraining struts 1060. This particular configuration of struts 1060illustrates that struts 1060 can be coupled to or attached to a distalend of a guidewire 932 or transition member 936 (FIG. 37). The length ofstruts 1060 can vary based upon the particular configuration of guidemember 1012.

A restraining mechanism 1064 maintains struts 1060 in a restrainedposition as shown in FIG. 43. In this embodiment, restraining mechanism1064 includes a tubular member 1062 attached to each strut 1060 and arestraining or actuating member 1025 disposed therein. Althoughreference is made to tubular member 1062 being attached to each strut1060, it can be understood that one or more tubular members 1062 can beattached to each strut 1060 and/or fewer than each strut 1060 includestubular member 1062.

Each tubular member 1062 is adapted to receive restraining or actuatingmember 1025. As shown in FIG. 43, when struts 1060 are restrained,tubular members 1062 are aligned to receive restraining or actuatingmember 1025. That is, each tubular member 1062 is staggered on adjacentstruts 1060 with respect to other tubular members 1062, such thattubular members 1062 line up from the proximal end to the distal end offilter assembly 1031. Restraining or actuating member 1025 is thendisposed through the series of tubular members 1062 to restrain struts1060 and prevents them from extending outwardly, as illustrated in FIG.43.

Restraining or actuating member 1025 extends from filter assembly 1031into a lumen of guidewire 1032 to terminate at a proximal end of guidemember 1012 and optionally extend beyond the proximal end of guidemember 1012. Alternatively, restraining or actuating member 1025 canextend proximally from filter assembly 1031 to exit through an aperture1069, depicted in dotted lines, before terminating at the proximal endof guide member 1012 and optionally extend beyond the proximal end ofguide member 1012. In this latter configuration, restraining oractuating member 1025 can be disposed externally to guide member 1012 orpartially externally to guide member 1012 as it extends to the proximalend of guide member 1012 and optionally extend beyond the proximal endof guide member 1012. It will be appreciated that a clinician orphysician can manipulate restraining member or mechanism 1064 to releasethe restraining force applied by restraining member or mechanism 1064.Alternatively, restraining member or mechanism 1064 can be optionallyoperated by an actuating assembly similar to that described herein, suchas, but not limited to, the actuating assembly described with respect toFIG. 6, or any other actuating assembly known by those of skill in theart.

Each tubular member 1062 coupled to struts 1060 can be fabricated from ametal, a plastic, polymer, a polymer, a synthetic materials, whether ornot the material is the same as that forming guide member 1012. In oneembodiment, each tubular member 1062 is a polymer tube, such as apolyimide or polyurethane tube that is fixed to respective struts 1060with adhesive. In another configuration, each tubular member 1062 is ametallic cut tube that may be attached to respective struts 1060 withand adhesive or solder. In still another configuration, each strut 1060includes an aperture through which actuating member 1025 passes torestrain struts 1060 and prevents the same from extending outwardly.

Referring now to FIG. 44 is an exemplary configuration of another filterassembly according to another aspect of the present invention. Thefeatures of functions of filter assembly 1131 are applicable to otherfilter assemblies of the present invention, and vice versa. Furthermore,the discussion related to the one or more other struts of filterassembly 1131 is applicable also to the struts associated with the guidemembers of the delivery devices of the present invention.

As depicted in FIG. 44, filter assembly 1131 includes a body 1162 andone or more struts 1160. Coupled to one or more struts 1160 is a filter1133. Extending from body 1162 through filter 1133 is an atraumatic tip1148, with associated coil 1158. For ease of explanation, therestraining member or mechanism associated with filter assembly 1131 isnot shown, however, it will be understood that any of the restrainingmembers or mechanisms described herein can be used to apply arestraining force to one or more struts of filter assembly 1131.

Struts 1160 extend from a body 1162 of filter assembly 1131. Althoughreference is made herein to struts 1160 being integrally formed withbody 1162, it can be appreciated that struts 1160 can be separatemembers coupled to body 1162. Further, struts 1160 can be integrallyformed with guidewire 1132 or separate members coupled to guidewire1132.

Each strut 1160 includes a distal portion 1162, a proximal portion 1166,and an intermediate portion 1164 disposed between distal portion 1162and proximal portion 1166. Struts 1160 may attach to filter 1133 on theexterior of filter 1133, on the interior of filter 1133, along the edgeof filter 1133, through filter 1133, or combinations of one or more ofthe proceeding. To provide additional surface area to connect each strut1160 to filter 1133, each strut 1160 can be configured so that distalportion 1162 has a cross-sectional dimension larger than intermediateportion 1164. Stated another way, distal portion 1162 can have a largersurface area than intermediate portion 1164. The large cross-sectionalarea provided by the cross-sectional dimension of distal portion 1162provides large area for bonding each strut 1160 to filter 1133. In thisconfiguration, a strong bond is created between each strut 1160 andfilter 1133.

Similarly, each strut 1160 can be configured so that proximal portion1166 has a cross-sectional dimension larger than intermediate portion1164, while optionally having a similar, larger, or smallercross-sectional dimension than distal portion 1162. By having a largecross-sectional dimension and hence large surface area, each strut 1160can apply a greater biasing force to extend strut 1160 outwardly todeploy filter 1133.

By varying the cross-sectional dimensions of distal portion 1162,intermediate portion 1164, and/or proximal portion 1166, the degree ofbias exerted by each strut 1160 to move distal portion 1162 toward thewall of a blood vessel can be varied. The biasing force can also bechanged through optionally varying the length of each strut 1160 and/orchanging the curvature of each strut 1160.

Although reference is made herein to each strut 1160 having theabove-referenced configurations, one skilled in the art can appreciatethat one or more of struts 1160 can be configured as described above.Further, each strut 1160 can optionally be configured differently sothat each strut 1160 can have similar or dissimilar biasing forcescompared to others struts 1160 of the same delivery device. Throughvarying the biasing forces, the delivery device can be used for avariety of different procedures or blood vessel configurations.

Struts 1160 can be formed from Nitinol, stainless steel, metals, alloys,composites, plastics, polymers, synthetic materials, or combinationsthereof. Each strut 1160 can have a generally straight distal portion1162, proximal portion 1166, and/or intermediate portion 1164.Alternatively, each strut 1160 can have a generally curved distalportion 1162, proximal portion 1166, and/or intermediate portion 1164.In still another configuration, each strut 1160 can have a combinationof one or more straight and/or one or more curved portions.

Coupled to body 1162, such as within a lumen or hole 1137, is anatraumatic tip 1148. The atraumatic tip 1148 can include a core wire1156 and a flexible coil 1158 disposed thereon. Core wire 156 passesthrough an aperture 1170 in a distal end of filter 1133. Alternatively,core wire 1156 passes through one or more pores formed in filter 1133.To secure filter 1133 to atraumatic tip 1148, a securing coil 1186surrounds a portion of coil 1158 and the distal end of filter 1133.Although this is one manner to connect filter 1133 to atraumatic tip1148, one skilled in the art can identify various other manners toconnect filter 1133 to atraumatic tip 1148. For instance, the distal endof filter 1133 can be bonded to atraumatic tip 1148 using adhesives,mechanical fasteners, crimping, seals, friction fit, press fit, or othermanners to connect filter 1133 to atraumatic tip 1148. In anotherconfiguration, filter 1133 is not connected to atraumatic tip 1148 butcan slide along a portion of atraumatic tip 1148.

Turning now to FIGS. 45 and 46, two exemplary embodiments of capturingdevice or mechanism capable of being used to capture the filter of thefilter assembly are depicted. After the filter is deployed, it isdesirable to capture the filter after the stenting operation has takenplace. More specifically, it is desirable to capture the embolicparticles that may have been captured by the filter and remove the same.

FIG. 45 illustrates a capture device 1200 according to one aspect of thepresent invention. Capture device 1200 includes a capture catheter 1202.As shown, capture catheter 1202 includes a capturing portion 1204 and apositioning member 1206 connected or attached to capturing portion 1204.Capturing portion 1204 has a distal end 1208 and a proximal end 1210.Capturing portion 1204 includes a lumen 1212 extending from distal end1208 to terminate at an aperture 1214 at proximal end 1210 thereof. Thedistal end 1208 optionally includes one or more radiopaque markers orbands 1216, only one being shown. Similarly, a proximal end ofpositioning member 1206 can include one or more radiopaque marker orbands 1216. More generally, capture device and any of the deliverydevices and guidewires of the present invention can include one or moreradiopaque indicators, whether such indicators are marker, bands, studs,or other radiopaque display elements.

Lumen 1212 is configured to receive a guidewire with attached filterassembly (not shown) of a delivery device. In one embodiment, lumen 1212can include a stop member 1218, depicted in dotted lines, with a hole1220 there through. A guidewire, as represented by dotted linesidentified by reference numeral 1232, passes through hole 1220 of stopmember 1218. The guidewire 1232 can have various configurations, suchas, but not limited to those described herein and others known to thoseskilled in the art.

Stop member 1218 prevents a filter assembly disposed at a distal end ofguidewire 1232 to pass through hole 1220 once capture catheter 1202 hasreceived within lumen 1212 the filter assembly associated with guidewire1232 sufficiently that the filter of the filter assembly is at leastclosed to prevent escape of embolic material. In one configuration, thefilter assembly and associated filter are completely enclosed by captureportion 1204 of capture device 1200. In other configurations, the filterassembly and/or filter are partially enclosed by capture portion 1204 ofcapture device 1200. One skilled in the art can identify various otherconfigurations of stop member 1218, so long as stop facilitatescompletely or partially capturing the filter assembly and/or the filterassociated with guidewire 1232.

Positioning member 1206 is attached to capture catheter 1202 and can beused to move capture catheter 1202 along guidewire 1232, whether suchmovement is caused by moving catheter 1202 relative to guidewire 1232,guidewire 1232 relative to catheter 1202, or combination thereof.Positioning member 1206 has sufficient stiffness that application of aforce at a proximal end 1224 can be transferred to longitudinal motionof capturing portion 1204 of capture catheter 1202. In oneconfiguration, positioning member 1206 is a solid member, while inanother configuration positioning member 1206 is partially or completelyhollow. Positioning member 1206 can be fabricated from a polymer, aplastic, polymer, a synthetic material, a metal, an alloy, combinationsthereof, or other material that can be used for medical devices and hasthe needed stiffness.

As illustrated in FIG. 46, an alternate embodiment of a capture device1300 is illustrated. As shown, capture device 1300 has a form of atubular member, whether such tubular member is completely hollow orpartially hollow along its length. The capture device 1300 includes acapturing portion 1304 disposed at a distal end 1308. A lumen 1312extends between distal end 1308 and a location proximal of distal end1308 to terminate at an aperture 1326. In one embodiment, the locationof aperture 1326 and the proximal end of lumen 1312 coincide; such thatlumen 1312 extends from proximal end 1310 to distal end 1308 of capturedevice 1300. Aperture 1326 is adapted to receive a guidewire 1332, in asimilar manner to aperture 1214 of FIG. 45. Lumen 1312 is configured toreceive a filter assembly of a delivery device (not shown). Moregenerally, lumen 1312 completely or partially receives a filter assemblyand/or filter associated with guidewire 1322.

Capturing portion 1304 is configured to prevent passage of filterassembly of the delivery device. In this exemplary configuration, thelength of lumen 1312 is optionally configured to prevent capturingportion 1304 from being advanced further over the filter assembly and/orthe filter thereof than is required. In other configurations, lumen 1312can be advanced over the filter assembly and/or the filter more than isrequired to capture the same. In another configuration, lumen 1312 caninclude a stop member similar to stop member 1218 discussed herein.Furthermore, capturing portion 1304 can optionally include one or moreradiopaque markers similar to markers 1216 disposed at and/or between adistal end and a proximal end thereof.

Generally, therefore, embodiments of the present invention can providesystems, methods, and devices that combine the functionality of aguidewire, a stent delivery device, a dilation balloon, an embolicprotection device, or subset grouping thereof, into a single deviceinsertable into a body lumen. In this manner, embodiments of the presentinvention reduce the number of devices needed to perform a procedure,decrease the time needed to perform the procedure, reduce the difficultyand complexity of the procedure, thereby creating the potential forsafer procedures and increased effectiveness to the patient.

Portions of the various delivery devices and associated dilationassemblies, stents, guide members, actuator assemblies, guidewires,filter assemblies, and other elements of the present invention can beused interchangeably one with another. Therefore, descriptions of onedelivery device and associated components and/or elements is alsoapplicable to other delivery devices described herein and such otherdevices as known by one skilled in the art in light of the disclosureherein.

The present invention may be embodied in other specific forms withoutdeparting all from its spirit or essential characteristics. Thedescribed embodiments are to be considered in respects only asillustrative and not restrictive. The scope of the invention is,therefore, indicated by the appended claims rather than by the foregoingdescription. All changes which come within the meaning and range ofequivalency of the claims are to be embraced within their scope.

1. A device configured to deliver a stent within a body lumen, thedelivery device comprising: a stent; a dilation assembly configured toassist with placing said stern within a body lumen, said dilationassembly being adapted to cooperate with a guidewire; a guide membercomprising a distal end portion at least partially surrounding saiddilation assembly and said stent, said guide member defining a lumenextending from a distal end of said guide member toward a proximal endof said guide member, said lumen being adapted to receive a guidewire; arestraining member adapted to apply a restraining force to said distalend portion of said guide member, said distal end portion of said guidemember being arranged to apply a restraining force to said dilationassembly and said stent when said restraining member applies arestraining force to said distal end portion of said guide member; and afilter assembly disposed distally of said dilation assembly upon saidguidewire, wherein said filter assembly, said guide member, saiddilation assembly, and said stent are substantially simultaneouslydisposed within the body lumen to deliver said stent to the body lumen.2. The device as recited in claim 1, wherein said dilation assemblycomprises: a dilation tube adapted to cooperate with said guidewire; adilation balloon mounted to said dilation tube, said dilation tubecomprising and interior portion; and an inflation tube in fluidcommunication with said interior portion.
 3. The device as recited inclaim 2, wherein said guidewire is at least partially disposed in saiddilation tube.
 4. The device as recited in claim 1, wherein said filterassembly comprises: a filter basket; and a filter attached to saidfilter basket.
 5. The device as recited in claim 4 wherein said filterbasket comprises one or more struts, wherein at least one of said one ormore struts is configured to bias outwardly.
 6. The device as recited inclaim 5, further comprising a second restraining member configured inrestrain said filter basket between a restrained position and a releasedposition.
 7. The device as recited in claim 6, wherein said secondrestraining member is a sleeve secured around said one or more struts.8. The device as recited in claim 7, wherein at least a portion of saidsecond restraining member acts as a stitching to secure said sleevearound said one or more struts.
 9. The device as recited in claim 6,wherein said second restraining member comprises a plurality of hingedportions, said plurality of hinged portions being secured by at least aportion of at least one actuating member.
 10. The device as recited inclaim 6, wherein at least a portion of said second restraining memberpasses through a gap between at least two of said one or more struts,wherein said second restraining member is secured around said one ormore struts.
 11. The device as recited in claim 6, wherein said secondrestraining member comprises one or more separable portions coupled toone or more of said one or more struts.
 12. The device as recited inclaim 11, wherein at least one actuating member cooperates with saidsecond restraining member, wherein said at least one actuating member isadapted to separate one or more of said one or more separable portionsto release the one or more struts.
 13. The device as recited in claim 6,wherein said second restraining member comprises a cord secured to oneor more of said one or more struts.
 14. The device as recited in claim13, wherein said cord is configured with a plurality of hoops, saidplurality of hoops being secured by at least a portion of at least oneactuating member
 15. The device as recited in claim 6, wherein saidsecond restraining member is a cord threaded through one or more of saidone or more struts.
 16. The device as recited in claim 6, wherein saidrestraining member is one or more tubular members individually attachedto one or more of said one or more struts, said one or more tubularmembers being aligned to receive at least a portion of at least oneactuating member.